Supplements to Reduce the Risk of Falls

Question:
Do any supplements improve balance or reduce the risk of falls?

Answer:
Moderate doses of vitamin D may improve balance and reduce the risk of falls in older adults deficient in vitamin D; however, be aware that too much vitamin D may actually increase the risk of falls.

When combined with resistance exercise, supplementation with protein or creatine may help to build muscle in older adults (muscle loss has been associated with an increased risk of falls).

Also, be aware that being deficient in vitamin B12 can cause problems with balance and gait, which could increase the risk of falls.

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COMMENTS

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Robert8632 April 13, 2016

I think the "risk of falls" warning is appropriate under the circumstances but I doubt that we will be issuing it 12-24 months from now.

The 2015 study behind this recommendation has been widely criticized as bias in search of evidence. Among other flaws, the study employed weird dosage regimes (e.g., 60,000 units once per month which would likely create a pro-inflammatory response in the gut), uncommon definitions of normal and low levels, a lack of control for variables known to be related (e.g., was calcium and/or vitamin K being co-administered), question-begging in the premise, and weak statistical power (the publication bar is virtually always set at a minimum of p<0.05; this study was p<0.09, unheard of!). When Medscape (an online community of practicing physicians) published this study, 93 physicians commented on it. Every comment was negative, pointing out research and/or clinical flaws.

In addition to the design and execution problems, it is equally plausible that the vitamin D increased physical activity, therefore increasing the probability of a fall among people who generally have balance problems. This explanation was not examined much less controlled for.

In contrast to this, a 2004 10 study meta-analysis and many other studies since then (some well-designed, some opportunistic) continue to reach the opposite conclusions.

I appreciate the openness of this forum. Keep up the good work.

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This CL Answer initially posted on 4/12/2016. Last updated 9/19/2018.

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